Tuesday, December 22, 2009

Clearly each of us have different ideas of what kind of privacy or lack of privacy we're comfortable with. But unless we're hermits, or never leave our home unless we're wearing a chador, there are clearly some kinds of public appearance we're willing to accept, since most of us are listed in the phone book, use credit cards, go on walks, go to church, participate in community activities, etc.

But where do we draw the line? Especially, why is online information something so many of us are uncomfortable with?

The names of myself and my family members, our pictures, addresses, phone numbers, places of work, schools, and a host of other information are, strictly speaking, all publicly available with a modicum of effort. (A private detective could collect all of that information in the space of an afternoon. Someone without the resources and training of a detective might have to work a little harder, but it wouldn't be difficult.) Why is it not OK for this information to be exposed publicly on Google or Facebook or any of the other places online where "social networking" or whatever people are pleased to call it is going on?

I think part of the problem is the anonymity of the way in which that information may be obtained. My neighbors, for example, know a bunch of stuff about me that isn't even publicly available in any sense of the word. Yet it doesn't bother me. I think it doesn't bother me because there is a reciprocity: I know the same kind of things about them, and we both know that we know. It's part of living in a community, and people who are reasonably sane are OK with that. It's part of who human beings evolved to be.

Information that's available online may be accessed by anyone, in the same sense that anyone may walk down my street, stop in front of my house, make notes, take pictures, all perfectly legal (in the USA - other countries may have stronger restrictions on what is permitted) as long as they don't trespass. However, someone who stops in front of my house stands a good chance of being noticed by me or my neighbors.

Someone who accesses information online is not likely to be noticed by anyone.

And I believe that is where the difference lies.

David Brin in his book "The Transparent Society" suggests that hiding behind secrecy and encryption is pointless for us. Sure, it's a bit creepy to think that complete strangers access this information, but it's essentially impossible for us to prevent it. No matter what lies we tell, or what permissions we restrict on our online profiles, the details of our lives are always accessible to people with power or money.

No, the thing that will keep our future from turning into something like Orwell's 1984 isn't stronger privacy, but stronger transparency. Brin suggests that the reason why people don't stare at each other in public is because they'll get caught staring. We need to bring the same thing to the web.

Maybe we should be able to see a list of people who went by our house on Streetview. Maybe we should get a message from Facebook when someone checks out our profile. And not just these things, which are in my opinion small potatoes. We should be able to see who ran a credit check on us, who sold our address to a mailing list, who passed along our credit card usage habits to a marketing firm. It's not as if we can really prevent it from happening, so instead we should be able to see it when it does happen.

People don't stare when they might get caught. It's a lesson Facebook and Google should probably adopt. And I'd love it if this two-way transparency were to become the law for everyone who collects information about us.

Sunday, November 08, 2009

I definitely have mixed emotions regarding the new health care reform bill. I don't know everything that's in it, yet, but what I do know bothers me intensely.

Perhaps I think of the entire health care issue a bit differently from most people?

For me health care is a public policy issue similar to the way we deal with fire departments, public school, or national parks. In other words, the choices we make here have an effect on all of us, not just on those of us directly involved. A house that burns down isn't just a problem for the home owner. People who don't know how to read or write in our modern world aren't just a problem for themselves. Losing the areas we've designated as national parks doesn't just mean fewer places to go and enjoy nature. And like them, people without adequate health care are not just a sad story to read about. The effects are far reaching, both economically and socially.

It's not like some people want to characterize it: we need to be nice to each other and take care of each other. I mean, that'd be nice, too, but adequate health care for everyone is necessary for rather more bloody minded, hard headed reasons.

So I see the whole thing as a three part problem.

Health care is too damned expensive. Bills are itemized down to the fare-thee-well. You're charged for a change in rubber gloves, for every single aspirin, and the charges are outlandish. Every doctor and p.a. that has a poke at you submits their own bill. If you walk out with something like a pair of crutches you may well end up getting a bill from some medical supply store in Timbuktu.

Didn't use to be like that.

Insurance is about risk management. Now, you might argue that you don't take risks, so you should pay less for your insurance than others who take more risks. Or perhaps you're willing to bear a greater risk. But that flies in the face of the economic realities of health care. Risk management works best when the entire population is included, rather than allowing groups to take some kind of privileged position.

In other words, a single payer system that has the entire US population as subscribers is what will be most efficient and most effective at managing the cost of health care.

Yup, no choice. But you're trying to hold onto an illusion of choice. It's not a real choice. Whatever insurance plan you currently have is governed by actuarial tables, coupled with some sort of commitment of profits to investors. Everything else devolves from there. Your own input here only means something if you incur catastrophic expenses that will have to be paid for by the part of the system outside of your insurance plan. And that's precisely the problem.

The tail is wagging the dog. The reason why there's even a question about how we deal with the health care issue is because there are far too many people making money doing everything but providing health care, and any attempt to change that is bound to generate a lot of opposition from a lot of very wealthy people who are trying to maintain the status quo. About 2/3 of all the money spent on health care goes here.

But in one respect health care reform has to deal with that: these millions of people currently employed doing everything from collecting payments to denying health care can't actually be tossed out into the streets by closing down the likes of Blue Cross Blue Shield, right?

Essentially, a health care plan has to do all of that.

It needs to find a way to return medical billing to sanity. Do away with the practice of charging $1,000 for a hang nail, all but $50 of which ends up being disallowed by the insurance plan anyway.

A single payer system means that you will be able to get medical care whenever you need it, and, more importantly, providers of medical care don't need to inflate costs to recoup from people with the ability to pay the money they lose on the people who don't have the ability to pay.

The hard part would be re-purposing the machinery currently devoted to inefficiency and greed, the health insurance companies and their employees. I gather there's a shortage of nursing staff and doctors. Hey, I have an idea.

Anyway, as far as I can tell, the recently passed health care bill does practically none of all that. I know, the Senate version is still to come, and then there's final conference version... I wouldn't be surprised to find that it makes some things worse.

So that's why I have these mixed emotions. Should I be happy that we had movement of any kind on this issue? Or should we have scrapped this bill and tried again later?

Thursday, October 22, 2009

There's a classic experiment in psychology.

Suppose you're watching a run-away railway car. It's big, it's heavy, it's going fast and out of control. A little way along the track splits, and the car might go right, or it might go left. On the right track a man is working, wearing hearing protection. There's no way you can warn him in time. On the left track a car is stalled with a family inside, mom, dad, two kids. They don't notice the coming disaster, either.

You can't know which way the run-away train is going to go. But which track would you prefer it to go on?

Suppose there's a switch by your hand. You can't tell which way the train is going to go, but if you press the switch, then the train will definitely go right. One man will be killed, but the family will survive.

Whatever choice you might make, most people will choose not to press the switch. They prefer the 50/50 chance of killing an entire family by not doing anything to the certain chance of saving their lives by doing something that will kill a man.

The reason for this is buried in our processing of moral choices. Moral thinking is something we all do instinctively, and in most cases we do it well enough. But under certain circumstances our moral judgment seizes up, like some kind of rickety steam engine that needs a bolt tightened. This is an excellent example of such an instance.

It is doubtful that any of us will ever be in the position that is described by that psychology experiment, right?

Wrong.

Right now tens of millions of parents in America face exactly that kind of a choice. An H1N1 flu epidemic is threatening this country. It is already hospitalizing and killing people around the world. The risk to our children is significant: at least 1 in fifteen of non-immunized children will be hospitalized due to the H1N1 flu. If the epidemic gets bad enough, then the overburdened health care system may well not be able to prevent many deaths.

But there is a certain risk to the vaccine, as well. The risk is tiny for most serious problems, on the order of 1/100,000 or less.

If parents do nothing, they risk a 1 in fifteen chance that their children will become seriously ill. If they get their children immunized, they risk a much lower, less than 1/100,000 chance that their children will become seriously ill.

And yet parents around the country are deciding not to immunize.

They're deciding not to press that switch, gambling a family's life.

In actual fact, these parents are doing worse than gambling their own family's life. Since non-immunized children will get ill and spread the disease, parents who do not immunize their own children are gambling with the lives of everyone else, as well.

But because of the rickety old steam engine that runs our brains, it is hard for them to recognize the immorality of this choice.

Friday, October 09, 2009

It was later than I thought. This morning everything seemed to be going well until I was about 10 yards away from the bus stop, and the bus went by.

I yanked out my cellphone - I use it instead of a watch - and checked the time. Sure enough. The bus was not early.

The bus runs up the street, but instead of going straight downtown it winds back into the next neighborhood. I have a good chance of catching it when it comes back around to a stop about a mile from that corner, so I started jogging. When I was about half-way there, someone called my name, and I get a ride with a neighbor.

Nice guy, give you the shirt off his back, and we haven't talked in a long time so there's a lot to cover. When talk turns to insurance, how much he's paying, how he has to be careful to stay insurable, how his deductible and copays about keep him broke, I say, "with all what we have to deal with, I wonder what they're talking about when they say national health care would eliminate choice."

"You'd be surprised," he says.

Well, I was surprised. I expected someone who isn't having any fun at all with the current health care system to be on the side calling for reform, but apparently not. There weren't any specific problems he meant. "You'd be surprised" is about all it amounts to.

There is a curious kind of cognitive disconnect when people don't trust government to run a health care system, but it's OK for government to send our sons and daughters off to war. On the one hand they raise a ruckus when the census comes around, and then they have no problem with warrantless surveillance. A health care system that bleeds them into poverty - most individual bankruptcies are due to medical bills - is OK, even if insurance company execs make billions and the care they receive is demonstrably inferior to that in any other industrialized country, but even a suggestion of raising taxes and out come the tricorns and the Tetley tea bags.

I'd go to Canada. I'm told their system doesn't work but Canadians aren't going bankrupt over their medical bills, they have a lower infant mortality rates, and longer life expectancies. If that is what it means when something doesn't work I welcome failure.

Monday, September 28, 2009

A chuckle on the digital age.

From an emailed editorial I was sent (don't know the original link):

"... Gordon Bell (and fellow Microsoft researcher Jim Gemmell) have written a book called Total Recall, in which they describe the benefits of recording literally everything we do in digital formats, and the process by which we're going down that road. Among the benefits they describe:

definitive and easily-accessible health records;

settling who-said-what disputes with your spouse;

being able to figure out who was at last year's Christmas party; and

never losing an important written document or photograph.

..."

OK, definitive and easily accessible health records: no one wants those. If "death panels" bothered people, the prospect of the lovely folks at an insurance company telling you, sorry, no, you're not covered for that bypass because we know you ate a Big Mac a week for the past ten years should be a lot worse. (Don't tell me that wouldn't happen. You know it would.) We want plausible deniability.

Settling who-said-what disputes with your spouse by playing back a recording has got to be the single most welcomed idea - by the divorce lawyers association. If that really worked, why wouldn't the spouse play back their own recording and avoid the dispute in the first place?

Christmas parties? If anyone knew you were recording those kinds of details, they wouldn't come to your party, and you wouldn't get invited. Figuring out who was there will be quite easy: not you.

Never losing an important written document or photograph. Yeah, right. Between disk crashes, lost backups, and not knowing where you filed it in those terabytes of indispensable information, good luck.

Why is it that tech mavens seem to have such tenuous contact with the real world?

Wednesday, January 21, 2009

Sometimes the shiny new present turns out to be not at all what you thought it was.

For reasons unrelated to the inauguration on Tuesday I was listening to classic rock, including The Who. Just before Obama gave his inauguration address, the song "Won't get fooled again" came on. I paused the song and turned on the sound to Obama's speech.

It was a nice job of speechifying, I thought. I enjoyed it when Obama gave Bush and the neo-cons their well deserved and public spanking. I liked Obama's retelling of the American Myth. I took the whole thing to be what it was intended: a spectacle to signal to the Rest of the World that the USA was still in business, and that a new hand was guiding the Ship of State.

Throughout the speech the camera switched from views of Obama at the podium to views of the crowds thronging the Mall. People with hopeful faces. The song I had just been listening to kept swirling through my mind as background to Obama's speech.

When the swearing-in was done with and the nattering nabobs of the media took their turns telling us what we'd just watched, I muted the stream and returned to my music. Next came the great guitar bridge from the song, followed by the last two lines, which sounded disturbingly prophetic: "Meet the new boss, same as the old boss."

I am by nature an optimistic person, but news items like this one from WiReD (which detail how Obama's administration is unlikely to return to principles of accountability, at least as far as the government's ability to spy on citizens without a warrant is concerned) certainly help to sober me up.

Tuesday, January 20, 2009

When we're about to anoint America's first president of African descent, some folks might call it churlish to suggest that there's still racism in America. Well, here's an article, published last year, which might change their minds. I have nothing to add.